Using EHR TO Quality Improvement

Using EHR TO Quality Improvement

Virtually all global companies have invested extensively in computerization over the last decade. Compared to a decade ago, more Americans today purchase airline tickets and check-in online flights, pick up products on the Internet and even receive online degrees from nursing, law, and business, among others. Given these developments in our hospital culture, however, most patients receive handwritten medications and very few are capable of sending an email to their doctor or even arrange their appointment to see a doctor without having to talk to a live recipient. Electronic health records (EHR) systems are capable of turning the healthcare system from a predominantly paper-based enterprise into a clinical that utilizes other information-based systems to help providers provide patients with quality treatment (Esquivel et al., 2012). The HITECH Act of 2009, a part of the United States Recovery and Reinvestment Action   was signed with the specific purpose of encouraging providers (e.g. hospitals and doctors) to use EHR systems. Given that a bare-bone EHR program only offers patients and healthcare providers with limited benefits, nevertheless, the HITECH Act allows manufacturers to implement and “sense” EHRs, which include utilizing other EHR features associated with error reduction as well as cost reduction (Alotaibi & Federico, 2017). How are EHRs improving Safety Issue, the effectiveness of healthcare providers as it relates to problems, the efficacy of healthcare services as it relates to problems (Cost / Benefit), equity of care and timeliness treatment precisely? And what is the latest proof of the advantages of such “useful” functionalities of EHR? The aim of this paper is to answer these questions.

The Problem

EHR is defined as a “patient medical information longitudinal electronic record, created from one or more meetings in any environment of healthcare. Patient demographics, progress points, issues, medicines, vital signs, previous medical histories, vaccines, laboratory data, and radiology reports should be included in this material. Two of the fundamental advantages associated with EHRs are the quick access to computerized records and the lack of inadequate penetration that has traditionally troubled the clinical chart. While several possible capability systems can be integrated into EHR, three particular functionalities are promising at the level of the healthcare system to increase patient quality and minimize the cost of treatment. These are clinical decision support (CDS), sharing of health information, and computerized medical order entry (CPOE) systems (‌ Alvandi, 2015). These and other EHR strengths are the provisions laid down in the HITECH Law of 2009 for “constructive use.”

A CDS program assists the healthcare provider in creating patient care decisions. Several features of a CDS system include having the latest medications and treatment information, a patient allergy cross-reference, and medication reaction warnings and other patient issues on the computer. Each of these features provides a way to provide much healthier and more reliable treatment due to the continued growth of clinical experience. When more and more CDS systems are in use, certain medical mistakes can be prevented and patients obtain more effective, efficient, equity of care, timeliness, and secure treatment in general.

Instead of being written on paper, the CPOE systems allow healthcare providers to submit orders on their computers (e.g. for medications, laboratory tests, radiology, physical therapy). Computerization prevents potentially dangerous medical mistakes attributable to incompetent doctors’ fine. This also increases order productivity as nursing and pharmacy staff are not forced to seek clarification or to request details from unreadable or incomplete orders. Past studies indicate that a CPOE system alone can minimize severe medicine errors by as much as fifty-five percent and by eighty-three percent when coupled with clinical decision support system produces warnings based on physician orders. A CPOE system can lead to improved quality and reliability of treatment, particularly when connected with a CDS (Menachemi & Collum,2011).

If health data is accessible to clinicians electronically, EHRs promote the exchange of patient information via health information exchange. Health information exchange is the process of exchanging electronic health information at the patient level among various organizations, which can make the provision of healthcare much more effective. Health information exchange is able to eliminate costly and unnecessary tests requested because one provider does not have access to any clinical stored information in another provider, through secure and potentially real-time exchange of patient information. Typically, patients have data collected in a number of locations where they get treatment. These may include their primary healthcare office and other physicians ‘ offices, one or more drugstores and other locations, such as hospitals and emergencies. Throughout a lifetime, a lot of data is collected in different places, all stored in silos. In the past, suppliers have faxed or mailed relevant information, making it impossible to access them when and where it is required in “real-time.” HIE makes it easier to share this data through EHRs, which can lead to much cheaper and better-quality care (Menachemi & Collum,2011).

Aims for Quality in IOM

Safety

In reality, safety remains at the heart of healthcare in order to maximize efficiency. Helping healthcare facilities provide better quality and healthier patient care by making measurable benefits for the organization, along with their ability to share information electronically (Esquivel et al., 2012). EHRs help physicians coordinate patient care efficiently and deliver quality health care through:

• Providing accurate, updated, and detailed patient information at the point of treatment.
• To permit easy access to the more organized and effective management of patient records.
• Secured sharing with patients and other clinicians of electronic knowledge.
• Services help treat patients more efficiently, reduce medical errors, and provide better care.
• Improving the engagement and contact between patients and caregivers and the quality of health care.
• To make medication safer and more secure.
• To help the development of readable, full, and correct coding and billing, simplified.
• Improving patient data privacy and protection.
• Enables providers to meet their daily goals and increase performance.
• Reducing costs by reducing administration, improving efficiency, reducing test duplications, and enhancing safety.

Effectiveness

Effectiveness as an ultimate goal of the provision of medical knowledge-based care and the prevention of redundant or unnecessary facilities. Without the use of electronic health records, a complicated medical history and treatment can be hard to access. Nevertheless, physicians are able to clearly identify specific patient conditions with digital records and quickly access detailed reports detailing every aspect of the health of a patient. Furthermore, Most EHR systems have the advantage of providing a patient portal and this significantly enhances the patient’s interest in healthcare. It provides you with quick access to your information and data, which has shown to boost patient follow-up questions (Alotaibi & Federico, 2017).

Efficiency

Healthcare Providers stand to gain most often from EHRs by improved guidance compliance, enhanced organizational processes and ease of access, the accuracy of patient reporting, tracking and monitoring capabilities, and decreased medication errors. EHR systems are an essential virtual aid for medical workers to provide confirmation and warning for diagnosis and treatment and thereby increase the quality and results of medication adherence by offering comprehensive medical support across a wide range of data. In turn, EHRs promote the collaboration and improved coordination of interdisciplinary teamwork with medical providers. In addition to accessing charts quicker, healthcare professionals can decrease liability attributable to improved decision-making and reporting, they can also better monitor patients, which increases analyzes and assessment. The utilization of EHR also increases the efficiency of pay-performance billing and help (‌Silow-Carroll et al., 2012).

Equity

Equal healthcare requires the fair provision of services, No matter what the features of the patient are. EHRs and associated technologies will increase equality through expanded access to quality healthcare, better access to patient data, and improved care for underserved communities. Yet these are Enhancements depend on the usage of the EHRs and other products from manufacturers that matter overwhelmingly Under-served for the (Alvandi, 2015).

Timeliness

Introducing an EHR in a company poses significant operational obstacles and opportunities for enhancing patient care and institutional performance. Implementing EHR requires time and effort and there would be an automatic reduction of time (Gecomo et al., 2020). The institution will use EHRs to increase productivity and save time through organizational engagement and redesign of workflows. Health institution should use EHRs for:

• Spend less time “trying to chase down Chart,” since all patient records will be available to all appropriate personnel at an accessible place.
• Save time and reduce negated insurance and pre-authorization inspections with a computerized health insurance form.
• Build templates for forms often used, such as school health forms, for fast and simple completion of forms.
• Store and pre-fill in details commonly used, so that patient charts don’t have to be reentered.
• Manage and store data safely, enabling patient data remote retrieval and recovery procedures.
• Creates time savings with faster central charts monitoring, specific requirements and drug requests, and other shortcuts.

Patient-centered

            EHRs support patients by reducing waiting time, increased access and health information management, Broadened use of best practices including encouragement for decisions to include the best available medical care, improved transparency, warnings and notifications for upcoming scheduled appointments, greater satisfaction, improved cost savings and reduced redundancy.

Planning and Collaboration

Four components should be developed to promote wellness, improve disease control, provide evidentiary care, and prevent illness, to succeed in implementing EHRs among healthcare practitioners and patients.

The medical record of the patient: The patient’s medical record is a lifetime management instrument that records the medical history and contains all traditional patient charts (i.e. patient demographics, performance reports, medicinal items, vital signs, vaccines, laboratory data, and radiology). The program provides for order entry processing, which enables health care and medication orders to be submitted and data collection enhanced. The importance of the knowledge it provides should lead to informed decision-making (Manca, 2015).

Decision support system (DSS): The DSS offers health care providers with a helpful tool to maximize the range of suitable solutions through warnings, reminders, and appropriate treatment suggestions based on existing best practices. The Decision support system is an ideal solution. This may also apply to management processes such as scheduling, accounting, and claim management which have a direct effect on treatment. This type of program provides clinicians with detailed intelligently interpreted knowledge to promote the most educated decisions that eventually improve healthcare. Health care practitioners can improve a patient’s diagnosis with this form of assistance. Including monitoring and dosage correctness of drug use; compliance with medication; medical precautionary reminders for vaccination, health risk monitoring, and detection; and the development of patient condition clinical recommendations to avoid a variety of adverse effects and misconceptions. Therefore, the Decision support system will impact outcomes for patients directly and indirectly (Esquivel, et al., 2012).

Component of medication prescription: The component of medication prescription assists clinician’s measure doses of drugs; decreases error potential; prevents drug interaction; and allows approved health care professionals to access, monitor, and safeguard the drug history of the patient. It also speeds up and guarantees quality treatment and tracks compliance and success of the patient (Agrawal, 2009).

Patient network access interface with the Internet: Several self-control devices have been developed to ensure patients have access to multiple health records, resources such as appointment bookings, and re-fills for prescriptions and computer-based digital patient care. It will enable secure methods for two-way communication, exchange of information, and enhancing the quality of care.

Quality Improvement

Improved Patient Outcomes & Diagnosis: Patients get better medical treatment when they have access to full and reliable details. Electronic health records (EHRs) can increase diagnostic efficiency and reduce medical mistakes and improve patient results, including prevention (Manca, 2015). Significant evidence is provided by a national doctor’s survey that is prepared for practical use: ninety-four percent of healthcare providers say they readily have information at the point of treatment for their EHRs, eighty-eight percent say their EHR provides clinical advantages for work, and Seventy-five percent of providers reported delivering improved patient treatment through their EHR. EHR’s allow clinicians to access the full health records of a patient with secure access. A full picture will allow clinicians to rapidly identify the conditions of patients.

EHRs can minimize mistakes, enhance the health of patients, and improve patient outcomes: It’s not just information that EHRs produce, or transmit; they “compute” the information. This ensures that EHRs manipulate data in ways that involve patients. For instance:

A professional EHR not only maintains notes of the drugs or conditions of a patient but also tests for concerns when a new prescription is prescribed; Data obtained by the healthcare professional in an EHR alerts a clinician in the emergency room about the life-threatening condition of a patient and emergency personnel, if the patient is not alert, will adjust treatment accordingly; EHRs can identify possible safety issues, help patients prevent more serious health complications and improve patient outcomes; and EHRs can help practitioners define and address organizational issues rapidly and systematically. Identifying these issues in a paper-based environment is much harder and it can take years to fix them (Gecomo et al., 2020).

Evidence-based

Medicare research on EHR downtimes, particularly in the clinical or hospital setting, is in its early stages. The frequency and extent of downtimes that hospitals in the US or other institutions around the world currently encounter are not tracked actively. Researchers discovered that the overall downtime interruption in the provision of treatment in an Australian 350-bed hospital was forty-nine hours per year, with a total downtime of fifty-one percent by 9.00 a.m. And 5 p.m., typically the busiest hospital workers period for the need for access to this network. Further research to assess the impact of downtimes on patient care and results are more needed as the global use of EHRs continues to increase (Gecomo et al., 2020).

In conclusion, Healthcare practitioners and patients reap various benefits from EHRs. Creating and innovating new models of practice provides efficient healthcare and improved patient safety and collaborative procedures at lower costs while implementing EHRs contributes to the sustainability and profitability of the health system. Furthermore, the importance of approaches to improve familiarity with the EHR among medical professionals and customers must be stressed during technological growth. The transition to the procurement complexities of acquisitions of information technology is a major step in creating an EHR. Crucial considerations are good occupational health training and primary communication approaches.

References ‌

Agrawal, A. (2009). Medication errors: prevention using information technology systems. British Journal of Clinical Pharmacology, 67(6), 681–686. https://doi.org/10.1111/j.1365-2125.2009.03427.x

Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631

‌ Alvandi, M. (2015). Optimizing the Effect of Electronic Health Records for Healthcare Professionals and Consumers. Retrieved July 27, 2020, from AJMC website: https://www.ajmc.com/journals/ajac/2015/2015-vol3-n3/optimizing-the-effect-of-electronic-health-records-for-healthcare-professionals-and-consumers?p=2

Esquivel, A., Sittig, D. F., Murphy, D. R., & Singh, H. (2012). Improving the Effectiveness of Electronic Health Record-Based Referral Processes. BMC Medical Informatics and Decision Making, 12(1). https://doi.org/10.1186/1472-6947-12-107

Gecomo, J. G., DNP, Klopp, R. A., Ph.D., RN, NHA, … Contributors, N.-B. O. J. of N. I. (2020, March 3). Implementation of an Evidence-Based Electronic Health Record (EHR) Downtime Readiness and Recovery Plan. Retrieved from www.himss.org website: https://www.himss.org/resources/implementation-evidence-based-electronic-health-record-ehr-downtime-readiness-and

Manca, D. P. (2015). Do electronic medical records improve the quality of care? Canadian Family Physician, 61(10), 846–847. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607324/#:~:text=Electronic%20medical%20records%20have%20been

Menachemi, N., & Collum. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 47. https://doi.org/10.2147/rmhp.s12985

‌Silow-Carroll, S., Edwards, J. N., & Rodin, D. (2012). Using electronic health records to improve quality and efficiency: the experiences of leading hospitals. Issue Brief (Commonwealth Fund), 17, 1–40. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22826903/

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